How do you measure trust in social institutions and health professionals? A systematic review of the literature (2012–2021)

The importance of measuring trust in health systems has been accentuated due to its correlation with important health outcomes aimed at reducing COVID-19 transmission. A systematic review published almost a decade ago identified gaps in measures including the lack of focus on trust in systems, inconsistency regarding the dimensionality of trust and need for research to strengthen the validity of measures. Given developments in our understandings of trust since its publication, we sought to identify new scales developed, existing ones adapted in response to identified gaps, and agendas for future research. Using the PRISMA approach for systematic reviews, we conducted a search in four databases. A total of 26 articles were assessed. Twelve new scales were identified, while 14 were adapted for different settings and populations. Literature continues to focus on measuring trust in health professionals rather than systems. Various shortcomings were identified, including some articles not mentioning the dimensions included in the scale and suboptimal use of validity and reliability testing and/or reporting. Moreover, a variety of terms were used for dimensions. Future research is needed to address these gaps and consequently, to understand their correlation with health behaviors and outcomes more accurately. © 2023 The Authors. Sociology Compass published by John Wiley & Sons Ltd.

COVID-19 Vaccine Hesitancy in a Developing Country: Prevalence, Explanatory Factors and Implications for the Future

Objectives Vaccine hesitancy is a public health challenge highlighted during the coronavirus 2019 (COVID-19) pandemic. This study sought to determine prevalence and explanatory factors leading to COVID-19 vaccine hesitancy in the Jamaican population to inform vaccination strategies. Study design Exploratory cross-sectional study. Methods An exploratory survey was distributed electronically between September and October 2021, to gather information on COVID-19 vaccination behaviour and beliefs among the Jamaican population. Data were expressed as frequencies and analysed using Chi-square followed by multivariate logistic regressions. Significant analyses were determined at p<0.05. Results Of the 678 eligible responses, most were females (71.5%, n=485), between ages 18-45 years (68.2%, n=462), had tertiary education (83.4%, n=564) and were employed (73.4%, n=498), with 10.6% (n=44) being healthcare workers. COVID-19 vaccine hesitancy was present in 29.8% (n=202) of the survey population, mainly because of safety and efficacy concerns and a general lack of reliable information about the vaccines. The likelihood of hesitancy increased amongst respondents under 36 years (OR 6.8, 95% CI 3.6, 12.9), those who delayed initial acceptance of vaccines (OR 2.7, 95%CI 2.3, 3.1);parents for their children and with long waits at vaccination centres. Likelihood of hesitancy decreased for respondents over 36 years (OR 3.7, 95% CI 1.8, 7.8) and with vaccine support from pastors/religious leaders (OR 1.6, 95%CI 1.1, 2.4). Conclusions Vaccine hesitancy was more prevalent in younger respondents who were never exposed to the effects of vaccine-preventable diseases. Religious leaders had more influence than healthcare workers to increase vaccine uptake.

COVID-19 vaccine hesitancy in a developing country: prevalence, explanatory factors and implications for the future.

OBJECTIVES: Vaccine hesitancy is a public health challenge highlighted during the COVID-19 pandemic. This study sought to determine the prevalence and explanatory factors leading to COVID-19 vaccine hesitancy in the Jamaican population to inform vaccination strategies. STUDY DESIGN: This was an exploratory cross-sectional study. METHODS: An exploratory survey was distributed electronically between September and October 2021 to gather information on COVID-19 vaccination behaviour and beliefs among the Jamaican population. Data were expressed as frequencies and analysed using Chi-squared followed by multivariate logistic regressions. Significant analyses were determined at P < 0.05. RESULTS: Of the 678 eligible responses, most were females (71.5%, n = 485), between ages 18-45 years (68.2%, n = 462), had tertiary education (83.4%, n = 564) and were employed (73.4%, n = 498), with 10.6% (n = 44) being healthcare workers. COVID-19 vaccine hesitancy was present in 29.8% (n = 202) of the survey population, mainly because of safety and efficacy concerns and a general lack of reliable information about the vaccines. The likelihood of hesitancy increased amongst respondents under 36 years (odds ratio [OR] 6.8, 95% confidence interval [CI] 3.6, 12.9), those who delayed initial acceptance of vaccines (OR 2.7, 95% CI 2.3, 3.1); parents for their children and with long waits at vaccination centres. Likelihood of hesitancy decreased for respondents over 36 years (OR 3.7, 95% CI 1.8, 7.8) and with vaccine support from pastors/religious leaders (OR 1.6, 95% CI 1.1, 2.4). CONCLUSIONS: Vaccine hesitancy was more prevalent in younger respondents who were never exposed to the effects of vaccine-preventable diseases. Religious leaders had more influence than healthcare workers to increase vaccine uptake.

Individual Altruism Cannot Overcome Congestion Effects in a Global Pandemic Game

A key challenge in responding to public health crises such as COVID-19 is the difficulty of predicting the results of feedback interconnections between the disease and society. As a step towards understanding these interconnections, we pose a simple game-theoretic model of a global pandemic in which individuals can choose where to live, and we investigate the global behavior that may emerge as a result of individuals reacting locally to the competing costs of isolation and infection. We study the game-theoretic equilibria that emerge from this setup when the population is composed of either selfish or altruistic individuals. First, we demonstrate that as is typical in these types of games, selfish equilibria are in general not optimal, but that all stable selfish equilibria are within a constant factor of optimal. Second, there exist infinitely-many stable altruistic equilibria;all but finitely-many of these are worse than the worst selfish equilibrium, and the social cost of altruistic equilibria is unbounded. Our work is in sharp contrast to recent work in network congestion games in which all altruistic equilibria are socially optimal. This suggests that a population without central coordination may react very poorly to a pandemic, and that individual altruism could even exacerbate the problem. © 2022 IEEE.

Social Kropotkinism: The Best ‘New Normal’ for Survival in the Post COVID-19, Climate Emergency World?

Pyotr Alexeyevich Kropotkin was originally an evolutionary biologist, writing shortly after Charles Darwin, who pointed to collaboration rather than competition as the underlying driver of (human) evolution, development and survival. This paper questions why ‘Social Darwinism’ has entered the language when ‘Social Kropotkinism’ has not. We position Social Kropotkinism – based on mutual support and community cooperation as opposed to Darwinian survival of the fittest – as having value as a new societal organising principle that can help to ensure social justice and equitable distribution of increasingly scarce resources in the post-pandemic, climate emergency world. We chart the re-emergence of Kropotkin’s ideas of mutualism against the current literature on the evolution of human cooperation, showing how the blossoming of community-level mutual aid during the COVID-19 pandemic, which has exposed and filled many cracks in UK Government provision of welfare and social care, is the inevitable end-result of the empathy and predisposition for cooperation that has underpinned the development of complex societies and civilisation. © 2022 Cole et al.

Experiences of newly qualified therapeutic radiographers who transitioned to work during Covid-19

Introduction The Covid-19 pandemic continues to impact on how radiotherapy is delivered, how staff do their job and how patients are cared for. Part of the UK NHS response to the covid-19 crisis was to accelerate final year radiotherapy students into work as therapeutic radiographers. The study objective is to explore the experiences of a cohort of new registrants who started work in May 2020. Methods In depth interviews were conducted remotely with newly qualified therapeutic radiography registrants regarding their first 12 months working in UK NHS cancer centres. Data were analysed within and across cases using a framework analysis and synthesised thematically. Results Eleven radiographers were interviewed, working across six different sites. Key generated themes are the risk of impaired professional socialisation due to incongruence between students’ expectations and the reality in clinical departments. We use Bridges Transitional Model to show how a combination of the disrupted/undefined end to university and a perceived lack of recognition of professional knowledge, skills and values evident in our data may leave participants stuck in a middle stage of the transition process. Slower than expected professional development led to demotivation, which was also associated with rising covid-19 case numbers. Conclusion The covid-19 pandemic accentuated and heightened the existing challenge of professional integration and socialisation faced by new therapeutic radiography staff. Demotivation and potentially attrition are more likely in this environment. Compassionate leadership that fosters the mentorship of junior cohorts as part of a flexible preceptorship package could mitigate these risks.

COVID-19 Vaccine Hesitancy in the Jamaican Populace: Prevalence and Associated Factors

Objective: To assess the prevalence and contributing factors towards COVID-19 vaccine hesitancy in the Jamaican population. Method(s): Following ethical approval, an exploratory online survey was distributed electronically to derive information on COVID-19 immunization behaviour and beliefs. Data were expressed as frequencies and analysed using Chi-squared followed by multivariate logistic regressions to determine associations and contributions of various factors towards the COVID-19 vaccine hesitancy. Significant associations were determined at p < 0.05. Result(s): Of the 678 respondents assessed, 71.5% were females, 68.2% between ages 18-45 years, 83.2% obtained tertiary education and 61.2% were employed, with 10.6% being healthcare workers. Most were from urban communities (69.5%) in Kingston & St. Andrew (42.1%) and St. Catherine (31.3%). COVID-19 vaccine hesitancy was present in 29.8% of the population but the likelihood doubled with age <36 years (OR: 1.9 (95% CI: 3.6, 12.9)) and tripled in those who initially delayed acceptance of the vaccine (OR: 2.7 (95% CI: 12.3, 3.1)). Even with acceptance of the vaccine, parents were 3 times more likely to delay the vaccine for their child (OR: 2.6 (95% CI: 1.2, 5.3). Likelihood of hesitancy decreased by >6 with belief that the vaccine was safe (OR: 6.2 (95% CI: 4.8, 7.8)), for ages = 56 years (OR: 2.5, 95% CI: 1.8, 7.8), healthcare workers, higher education, and receipt of other recommended vaccines. Conclusion(s): Prevalence of COVID-19 vaccine hesitancy was 29.8%, with increased odds amongst respondents younger than 36 years, with parenthood and delayed initial vaccine acceptance. Hesitancy decreased for persons older than 36 years, for healthcare workers and with higher education and belief that the vaccine was safe.

Building Capacity: Enhancing Undergraduate STEM Education by Improving Transfer Success

Several evidence-based practices were combined to reduce barriers to transfer from associate to baccalaureate programs, and baccalaureate degree completion. The first strategy was creation of the STEM Transfer Collaborative (STC), an adaption of the CUNY Pathways general education articulation initiative (1). The STC focuses on collaboration by both the sending and receiving college faculty to begin transfer preparation and support before transfer occurs, through articulation agreements, shared professional development to align pedagogy and curriculum, and outreach to potential transfer students. There was also regular feedback to community college faculty on the success of their transfer students. A second strategy employed was Momentum to the Baccalaureate (MB), an adaption of the CUNY Accelerated Study in Associate Programs, ASAP (2). MB provides support for junior and senior-level transfer students who are either community colleges associate degree graduates (external transfer) or associate degree graduates who transferred to bachelor's programs at the same comprehensive college they earned their associate degree at (New York City College of Technology of the City University of New York), which has a 2+2 degree structure (internal transfer). Components of MB include personalized mentoring, advisement, and monthly stipends to students who maintain full-time enrollment and good academic standing. Students' majors are in high needs STEM areas and include computer engineering technology, computer systems technology, construction management and civil engineering technology, electrical engineering technology, and applied chemistry. Propensity matching was used to evaluate the effectiveness of these strategies. Participating campuses are part of the City University of New York (CUNY), and include six community colleges (Borough of Manhattan Community College, Bronx Community College, Guttman Community College, Hostos Community College, Kingsborough Community College, and LaGuardia Community College), five of which are Hispanic Serving Institutions (HSIs), and, as mentioned previously New York City College of Technology (City Tech), also an HSI, which offers associate and bachelor's degrees (2+2 structure). Building Capacity: Enhancing Undergraduate STEM Education by Improving Transfer Success has made progress and demonstrated success at achieving goals, despite the ongoing challenges of the COVID-19 pandemic. Overall, preliminary results suggest that targeted pre-transfer and post-transfer supports improve transfer student outcomes. Students who transferred from a City Tech associate degree program to a City Tech STEM baccalaureate program and who received MB support had higher GPAs and better retention rates than a matched cohort of students who transferred from a City Tech associate degree program to a City Tech STEM baccalaureate program but who did not receive MB support. Students who transferred from a STEM Transfer Collaborative (STC) community college to City Tech's STEM baccalaureate programs who received Momentum to the Baccalaureate (MB) support had significantly higher GPAs compared with a matched cohort of students who transferred from a STEM Transfer Collaborative (STC) community college to City Tech's STEM baccalaureate programs but who did not receive MB support. © American Society for Engineering Education, 2022.

Robust Stochastic Stability in Dynamic and Reactive Environments

The theory of learning in games has extensively studied situations where agents respond dynamically to each other by optimizing a fixed utility function. However, in many settings of interest, agent utility functions themselves vary as a result of past agent choices. The ongoing COVID-19 pandemic provides an example: a highly prevalent virus may incentivize individuals to wear masks, but extensive adoption of mask-wearing reduces virus prevalence which in turn reduces individual incentives for mask-wearing. This paper develops a general framework using probabilistic coupling methods that can be used to derive the stochastically stable states of log-linear learning in certain games which feature such game-environment feedback. As a case study, we apply this framework to a simple dynamic game-theoretic model of social precautions in an epidemic and give conditions under which maximally-cautious social behavior in this model is stochastically stable.

Forecasting subnational COVID-19 mortality using a day-of-the-week adjusted Bayesian hierarchical model

As of October 2020, the death toll from the COVID-19 pandemic has risen over 1.1 million deaths worldwide. Reliable estimates of mortality due to COVID-19 are important to guide intervention strategies such as lockdowns and social distancing measures. In this paper, we develop a data-driven model that accurately and consistently estimates COVID-19 mortality at the regional level early in the epidemic, using only daily mortality counts as the input. We use a Bayesian hierarchical skew-normal model with day-of-the-week parameters to provide accurate projections of COVID-19 mortality. We validate our projections by comparing our model to the projections made by the Institute for Health Metrics and Evaluation and highlight the importance of hierarchicalization and day-of-the-week effect estimation. © 2020 John Wiley & Sons, Ltd.

Covid-19, pandemic risk and inequality: emerging social science insights at 24 months

In this editorial, we introduce a special thematic collection of articles published in this current issue, and earlier in 2021, which develop a range of social science approaches to studying and theorising pandemic risk, largely focused on the COVID-19 pandemic. We structure this editorial essay in two parts. First, we consider the challenges of theorising pandemics with an attentiveness to inequality. We consider what different theoretical approaches have brought and can bring to studying risk and inequality, before developing a more in-depth consideration of the work of Mary Douglas for this purpose. We draw out key features of Douglas's work on 'centre and periphery', alongside the related group dynamics and tensions which are configured by, and help reproduce, social inequalities. Second, we then develop a dialogue between these analytical sensibilities around inequality, drawn from Douglas, and various conceptualisations and findings emerging in the eight studies published on pandemics in Health, Risk and Society this year (4 in this issue, 4 appearing earlier in the year). Douglas's work, which has often been neglected in studies of inequalities and risk, provides valuable insights into institutional dynamics of culture and power. The eight recent studies in the journal include some conducted in contexts, and by researchers, located towards the global economic and academic periphery. This diversification, beyond the usual social and governmental contexts, and alongside the growing involvement of different epistemic communities, introduces and cultivates valuable insights, for the field of risk, inequality and health more generally, and for grasping the global phenomena of the pandemic.

Acute Leukemia and COVID-19: The Johns Hopkins Experience

Introduction: At the beginning of the COVID-19 pandemic in the United States, some states combated viral spread via lockdowns. In Maryland, where Johns Hopkins Hospital (JHH) is located, the closures began with public schools (March 12, 2020;3/12/20);followed by bars, restaurants, movie theaters, gyms and gatherings of >50 people (3/16/20) with 250 Maryland State Police troopers being activated to aid in enforcement. All non-essential businesses were closed on 3/23/20, with a statewide “stay-at-home order” announced on 3/30/20. At this time, we anecdotally noted a decline in the number of adult patients presenting to JHH with new diagnoses of acute leukemia (AL). In this retrospective study, we quantified changes in new AL diagnoses over this period. Methods: The study was approved by the JHH IRB. All patients with new presentations of AL undergo diagnostic flow cytometry (FC) analysis at our institution on peripheral blood and/or bone marrow samples. The FC database was searched for new diagnoses of adult (≥ 18 years) and pediatric (<18 years) AL during the following timeframes: [1] 3/13-6/10/20 (90 days after the first announced restriction) and [2] 2/11-3/12/20 (30 days prior to the first restriction). The database was searched for the same time periods in 2019 (3/13-6/10/19 and 2/10-3/12/19). A diagnosis of AL was considered new if the patient had not previously been diagnosed with AL or evolved to AL from an underlying myeloid neoplasm. Clinical data were collected from the electronic medical record. We used a Fisher's exact test to compare the distribution of new patients in the 30 days prior and 90 days following the announced COVID-19 restrictions in Maryland in 2020 to that of new patients in the corresponding time periods for 2019. The Cochran-Armitage test was used to compare trends in new patients with AL in the 30 days prior and 90 days following COVID-19 restrictions, as compared to the same time period in 2019. Statistical significance was defined as a p-value <0.05. Results: Between 3/13- 6/10/20, there were 25 new diagnoses of AL (11 women/14 men) with a median age of 51 years (range: 2.6 - 89 years;10 pediatric/15 adult). During the same 90 day period in 2019, there were 32 new diagnoses of AL (18 women/14 men) with a median age of 63 years (range: 8 - 93 years;2 pediatric/30 adult). Figure 1 shows the distribution of new AL diagnoses in adult patients by date of presentation. This decrease was most pronounced in the first 30 days, in which only one new adult patient with AL presented to JHH. The distribution of adult patients diagnosed in the 30 days prior and 90 days following the March 2020 restrictions was significantly different from the corresponding time period in 2019 (p=0.03);however, the overall trend of new adult AL diagnoses in the 30 days prior and the 90 days following the March 2020 restrictions was not significantly different from the corresponding time period in 2019 (p= 0.77). Of note, many patients with AL reported symptoms that overlapped with those of COVID-19 including fatigue (40%), dyspnea (35%) and fever (22%). 35.1% of patients diagnosed with AL after restrictions had no characteristic symptoms of COVID-19, as compared to 12.5% of patients diagnosed with AL during this period in 2019 (Table 1). Discussion: These data suggest that new presentations of adult AL were delayed by COVID-19-related restrictions. Given the acuity of AL, this delay may have affected clinical outcomes. Interestingly, pediatric new AL cases did not decrease during this time period. The reasons are unclear, though parents appear to have remained willing to seek care for their children even during the uncertain days at the beginning of the pandemic, perhaps due to the media reporting that COVID-19 infection was less aggressive in young people. Given the possibility of additional lockdowns due to COVID-19 variants or new pandemics, these data highlight the importance of encouraging patients to seek care in the event of illness, screening patients for both infectious and non-infectious diseas , and ensuring that routine medical care remains accessible. [Formula presented] Disclosures: Brown: Kura: Membership on an entity's Board of Directors or advisory committees;Amgen: Membership on an entity's Board of Directors or advisory committees;Takeda: Membership on an entity's Board of Directors or advisory committees;Novartis: Membership on an entity's Board of Directors or advisory committees;KIte: Membership on an entity's Board of Directors or advisory committees. Webster: AmGen: Consultancy;Pfizer: Consultancy.

Exploring the impact of gender on challenges and coping during the COVID-19 pandemic

Purpose Repercussions to everyday life caused by the COVID-19 pandemic disproportionately impacted certain segments of the population, including older adults, communities of color and women. The societal response to reduce the impact of the pandemic, including closing schools and working from home, has been experienced differentially by women. This study explored how individual challenges and coping mechanisms differed for women as compared to men. Design/methodology/approach This study used an anonymous, cross-sectional, online survey early in the COVID-19 pandemic. Convenience, snowball and purposive sampling methods were used. Data were collected in June 2020 targeting adults living in Canada and the USA, with a total of 1,405 people responding, of which, the respondents were primarily women, White and with high education levels. Findings The results of this study confirm previous research that women struggled more to adapt to the pandemic and felt less prepared than men during the COVID-19 pandemic. Further, this study found significant differences in the sources of information and support used by women as compared to men. Originality/value The findings of this study not only confirm past research but also highlight that practice and policy responses to this pandemic, and future research on national level crises need to be targeted by gender, so that different needs are effectively addressed. Additionally, this article also identifies sources or challenges, as well as support, in order to inform and strengthen such responses.

Two Epidemics and a Pandemic: The Collision of Prescription Drug Misuse and Racism during COVID-19.

The present study investigated the relationship between perceived racial discrimination and prescription drug misuse (PDM) among Asian, Black, and Latinx Americans during the COVID-19 crisis. U.S. racial/ethnic minorities may have been uniquely affected by two national and one global pandemic: the opioid crisis, racism, and COVID-19. Opioid death rates increased among many groups prior to the pandemic. This country witnessed an increase in racialized acts against people of color across the spectrum in the spring and summer months of the world's COVID-19 outbreak. While studies have shown a clear link between perceived racial discrimination and substance abuse outside of the global pandemic, no identified studies have done so against the backdrop of a global health pandemic. Separate hierarchical regressions revealed a significant association between perceived racial discrimination and PDM for Black Americans, Asian Americans, and Latinx individuals. Findings build on the scant literature on PDM in diverse samples and establish a relationship between perceived racial discrimination and PDM, as previously identified for other abused substances. Future post-pandemic substance misuse interventions should consider the influence of perceived racial discrimination as they help individuals recover from the aftermath of this stressful trifecta.

Venezuela: Background and U.S. relations

Venezuela remains in a deep crisis under the authoritarian rule of Nicolas Maduro of the United Socialist Party of Venezuela. Maduro, narrowly elected in 2013 after the death of Hugo Chavez (president, 1999-2013), began a second term on January 10, 2019, that is widely considered illegitimate. Since January 2019, Juan Guaido, president of Venezuela's democratically elected, opposition-controlled National Assembly, has sought to form a transition government to serve until internationally observed elections can be held. The United States and 57 other countries recognize Guaido as interim president, but he has been unable to harness that diplomatic support to wrest Maduro from power. Venezuela's economy has collapsed. The country is plagued by hyperinflation, severe shortages of food and medicine, and a dire humanitarian crisis that has further deteriorated in 2020 as a result of gasoline shortages, an outbreak of Coronavirus Disease 2019 (COVID-19), and strengthened U.S. sanctions. Maduro has blamed U.S. sanctions for the economic crisis, but many observers cite economic mismanagement and corruption as the main factors. U.N. agencies estimate that 5.1 million Venezuelans have fled the country as of August 2020, primarily to neighboring countries. U.S. Policy Since recognizing the Guaido government in January 2019, the United States has coordinated its efforts with Interim President Guaido. U.S. strategy has emphasized diplomatic efforts to bolster support for Guaido;targeted sanctions and visa revocations to increase pressure on Maduro officials;broader sanctions on the state oil company, other state-controlled companies and institutions, and the government;and humanitarian aid ($534 million to countries sheltering Venezuelans and $76 million for Venezuela from FY2017 through May 2020). In October 2019, the U.S. Agency for International Development (USAID) signed an agreement with the Guaido government enabling the provision of development assistance and increased democracy assistance. In 2020, the Administration has sanctioned companies that have transported Venezuelan oil and seized Venezuela-bound ships carrying Iranian petroleum products in violation of sanctions. U.S. officials have vowed to keep "maximum pressure" on Maduro and his foreign backers until he agrees to allow a transition government to convene free and fair legislative and presidential elections. Congressional Action Congress has supported the Administration's efforts to support a restoration of democracy in Venezuela without U.S. military intervention in the country and to provide humanitarian support to Venezuelans, although some Members have expressed concerns about the humanitarian impact of sanctions. In December 2019, Congress enacted P.L. 116-94, which appropriates $30 million in FY2020 assistance for democracy programs in Venezuela and incorporates the Senate-reported version of the VERDAD Act (S. 1025), a comprehensive bill to address the crisis in Venezuela. The VERDAD Act incorporated House-passed measures authorizing FY2020 humanitarian aid to Venezuela (H.R. 854), restricting the export of defense articles to Venezuela (H.R. 920), and requiring a U.S. strategy to counter Russian influence in Venezuela (H.R. 1477). In December 2019, Congress also enacted P.L. 116-92, which prohibits federal contracting with persons who do business with the Maduro government. In July 2019, the House passed H.R. 549, designating Venezuela as a beneficiary country for temporary protected status;however, a Senate effort to pass H.R. 549 by unanimous consent failed. For FY2021, the Administration requested $200 million in democracy aid aimed to support a democratic transition in Venezuela and $5 million in global health assistance;the House-passed version of the measure (H.R. 7608, H. Rept. 116-444) would provide $30 in democracy aid for Venezuela and support the provision of additional aid if a democratic transition occurs. The House-passed version of the FY2021 National Defense Authorization Act (H.R. 6395, H. Rept. 116-442) would require a report on he crises in Venezuela and its impacts on U.S. and regional security. © 2021 Nova Science Publishers, Inc.

Towards an Administrative Law of Central Banking

A world in turmoil caused by Covid-19 has revealed again what has long been true: the Federal Reserve is arguably the most powerful administrative agency in government, but neither administrative-law scholars nor the Fed itself treat it that way. In this Article, we present the first effort to map the contours of what administrative law should mean for the Fed, with particular attention to the processes the Fed should follow in determining and announcing legal interpretations and major policy changes. First, we synthesize literature from administrative law and social science to show the advantages that an agency like the Fed can glean from greater openness and transparency in its interpretations of law and in its long-term policymaking processes. These advantages fall into two categories: (1) sending more credible signals of future action and thereby shaping the behavior of regulated parties and other constituents, and (2) increasing the diversity of incoming information on which to base decisions, thereby improving their factual and predictive accuracy. Second, we apply this framework to two key areas monetary policy and emergency lending to show how the Fed can improve its policy signaling and input diversity in the areas of its authority that are most expansive. The result is a positive account of what the Fed already does as an administrative agency and a normative account of what it should do in order to preserve necessary policy flexibility without sacrificing the public demands for policy clarity and rigor.

Technocratic pragmatism, bureaucratic expertise, and the federal reserve

The Federal Reserve (Fed) regularly faces novel challenges to its broad statutory mandates. Often, these challenges—from financial crises to pandemics to climate change—raise a critical question. When should the Fed act beyond the boundaries of its core institutional identity and expertise? On the one hand, some voices demand the Fed “stay in its own lane,” avoiding experimentation so that it may preserve its perceived legitimacy to carry out core historical func-tions. On the other, hewing too closely to precedent and existing expertise risks institutional fail-ure of a different sort. To navigate that tension, this Feature sketches an ethos of technocratic pragmatism—one that permits the Fed to develop the expertise necessary to address emergent problems as long as it remains constrained by norms designed to preserve its long-run legitimacy. We illustrate the ethos by examining three cases where the Fed has confronted, or is confronting, challenges that test the boundaries of its expertise: engagement with cyber risk, emergency lending before and during the COVID-19 pandemic, and nascent efforts to understand the intersection of central banking and global climate change. We also engage with cases where the Fed has transgressed legitimacy-pre-serving limits by intervening in policy disputes beyond the range of its statutory concerns. Taken together, these cases illustrate how the Fed must walk a fine line between valuable experimentation and the usurpation of politics. © 2020, Yale Journal on Regulation. All rights reserved.

Increasing need for telehealth services for families affected by dementia as a result of Covid-19

There is no doubt that families affected by dementia have faced many new challenges as a result of Covid-19. The suspension and closure of support services, enforced lockdown and changes to important daily routines have influenced the way in which families affected by dementia have gained support. Health and social care services have recognised the need to adapt by incorporating telehealth as a substitute to existing care models;however, some have faced challenges in providing such care to this patient population. This paper explores the use of telephone helplines as a means of support for families affected by dementia during Covid-19, commenting on the advantages and disadvantages and reflecting on the experience of a dementia specialist helpline nurse. © 2020, JCN. All rights reserved